Measurement and Assessment of Pain In Children - A Review

Abstract

Pain is a common experience during childhood. Despite the magnitude of effects that pain can have on a child, it is often inadequately assessed and treated. Numerous myths, insufficient knowledge among caregivers, and inadequate application of knowledge contribute to the lack of effective management. The pediatric pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Pain is an inherently subjective multifactorial experience and should be assessed and treated as such. Pediatric Dentists are responsible for eliminating or assuaging pain and suffering in children when possible. To accomplish this, we need to expand our knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly. As an assessment of pain which constitutes the foundation for all pain treatment, developing valid measures is both a clinical and research challenge. Clinicians and researchers should select measures with full knowledge of their psychometric strengths and weakness, as well as in keeping with their explicit conceptual model of pain. The purpose of this paper is to address potential sources of pain measurement, and responses to pain control and distractions based on the pediatric developmental stages.

Does audiovisual distraction reduce dental anxiety in children under local anesthesia? A systematic review and meta‐analysis

“…Children undergoing painful dental procedures manifest responses indicating mental pressure, which leads to physiological changes (Chapman, ). Anxiety and discomfort increase sympathetic tone and promote the release of corticosteroids, glucagon, catecholamines, and growth hormones (Jain, Yeluri, & Munshi, ). These factors increase heart rate and constrict vessels, leading to a decrease in blood oxygen saturation levels (Agarwal, ).…”

Managing Pediatric Pain in the Emergency Department

“…If a self-report scale is being used to measure pain, it is essential the healthcare provider verifies that the child understands it. Published reviews and systematic reviews are available that can help us choose the appropriate pain scale; unfortunately there is no universal pain scale that can be used for all children (Table 1) [7,[15][16][17][18][19][20][21]. Regardless of the pain scale used, the meaning of specific scores should be determined as well as the limitations of each scales used [22].…”

“…Studies that evaluate other oral NSAIDs, including naproxen, in the ED are needed. Based on the results of the systematic review, we can conclude that, for the initial treatment of mild acute pain in children in the ED, it is probably better to administer ibuprofen first, Studied age [16] Score Treatment threshold [22] Psychometric properties a [21] Evidence-based assessment b [142] AHTPS [143] Observational …”

Procedural and postoperative pain in paediatric dentistry

“…Some authors (e.g., Nutter, 2010) differentiate the terms acute pain and procedural pain, while others (Jain, 2012) include procedural pain in the overall concept of acute pain. Procedural pain is pain related to an intervention: for example, in the course of medical or dental procedures (McGrath & DeVeber, 1986;Zeltzer et al, 1989;Yaster et al, 1997;Olsson, 2019).…”

“…Most preschoolers, around the age of two years, can communicate the presence of pain, and they gradually develop the ability to differentiate pain intensity in simple terms, such as 'none', 'a little', and 'a lot' when they reach the age of three to four (McGrath, 2005;Jain, 2012). However, such young children cannot fully comprehend the cause and meaning of pain, which is why they might exhibit irrational fear and resistance in painful situations.…”